Five years ago, I wrote a post on this blog—childmyths.blogspot.com/2015/08/craig-childress-tries-to-drag.html—where
I expressed my concern about the attempts of the California psychologist Craig
Childress to “explain” in terms of attachment theory why some preteen and
teenage children avoid one of their divorced parents.
This parent avoidance phenomenon is sometimes referred
to as “parental alienation” (PA), of course, and advocates of PA belief systems
attribute the avoidance to skulduggery on the part of one of the parents, who maliciously
turns the child against the avoided parent. As there is no adequate research and
little theory about parent avoidance, there was a bit of room for Childress to
put forth his take on it, which he did in a self-published book, a
self-published pamphlet, a blog and a (now private) Facebook page.
Childress’s basic idea is that a child with a normal emotional
attachment to a parent can have not only that attachment, but the whole “attachment
system”, suppressed by the manipulations of the other parent. Why does that
parent do the manipulating? Easy, according to this view; she (usually but not always) has a
narcissistic/borderline personality disorder that has developed because she was
in a condition of disorganized attachment as a toddler. That condition arose
because one or both of the parent’s parents had been traumatized and hence
behaved toward the child in ways that were both frightening and frightened.
None of these steps (except the source of disorganized attachment, if any) makes any sense in terms of what
we know about attachment and later development. First, early attachment status
is by no means a perfect predictor of later personality characteristics. A
longitudinal study following individuals from birth to early adulthood showed
that (Sroufe, 2005). Second, although there have been many queries about the
outcome of disorganized attachment (a state in which toddlers behave strangely
in circumstances where you would expect them to go close to a parent for
comfort), the evidence seems to be that it does not result in a personality disorder.
Third, even if a parent were able to suppress the child’s attachment system,
logically this would interfere with all child-caregiver relationships and could
not be finetuned to affect attitudes toward one parent and not the other.
Fourth—and very important—children who avoid a divorced parent and are said to
have PA are usually preteens or teenagers. Their ways of feeling and showing
emotional attachment are vastly different from those of toddlers, they thrive
without much parental presence unless some adverse circumstances disturb them,
and in fact they are beginning to seek peers in friendship or romantic
relationships that will soon replace the comfort and security that parents used
to offer.
I said a lot of this about Childress’s views, a long
time ago. Why bring it up again? The current problem has to do with discussions
about the International Classification of Diseases published and periodically
revised by the World Health Organization. The eleventh edition of this publication
(ICD-11) is presently under construction, and a comment page allows interested
people to propose and discuss various concerns. PA advocates, who failed to get
PA included in DSM-5 in the United States, are hoping for some inclusion in
ICD-11. The argument until just recently has been that PA cannot be listed as a
diagnosis, but could be listed as an index term that would take the reader to
the topic of “parent-child relationship problem”, obviously a category much
broader than, and not necessarily including, PA.
In the last few days, however, it has been proposed
that parent avoidance should be classified as an attachment disorder—and a few
contributors have cited Childress as a source for this. One proposal lists
criteria that are identical with lists of PA characteristics, but does not use
the PA term.
So, could it make sense to think of PA as an
attachment disorder? No, it could not. There are attachment disorders listed in
both DSM-5 (and previous editions) and ICD-10. These are disorders of social
relationships that appear to stem from a child’s history of caregiving and
separations from caregivers; salient events in that history would have occurred
during the period when emotional attachments usually form, about 10 months to 3
years of age. Reactive Attachment Disorder, for example, can only be diagnosed
if there is a history of problematic caregiving in early life AND if symptoms begin
before age 5 years.
Parent avoidance, on the other hand, is most often
seen (and labelled PA) in children in the preteen and teenage years. The
avoided parent usually states that the child was normally attached to him (or
her) but now refuses contact. The early period when attachment forms is
asserted to have been normal, and no problems or changes of caregiver are
reported. These children are thus past the age when attachment disorders begin
to show symptoms, and they do not have the problematic caregiving history
associated with genuine attachment disorders.
What would be the advantage to PA advocates of
claiming that attachment problems are the cause of children avoiding parents?
One advantage is that there is a huge literature on attachment that authors may
reference as supporting their thinking, as Childress frequently cites Bowlby.
PA authors can be fairly sure that most of their audience, though they may have
heard of Bowlby, actually have no idea what Bowlby said, when he said, to what
extent he had an evidence basis, or to what extent he changed his mind. But
everybody knows that attachment is good and attachment problems are bad, so
this suggests that anyone concerned about a lack of attachment must be fighting
the good fight.
Claims about attachment disorders may also win for PA
advocates an added concern related to pseudoscientific views of known attachment
disorders. Charlatans presenting their perspectives on Reactive Attachment
Disorder, for example, have asserted that children with attachment disorders
grow up to be antisocial, callous, cruel, even psychopathic. (Narcissistic/borderline,
anyone? ) There is no evidence that this is true, but it would certainly be
persuasive to a parent who knew no better.